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Volume 18, Number 9—September 2012

CME ACTIVITY - Policy Review

Control of Fluoroquinolone Resistance through Successful Regulation, Australia

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 70% passing score) and earn continuing medical education (CME) credit, please go to www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title: Control of Fluoroquinolone Resistance through Successful Regulation, Australia

CME Questions

1. You are a public health official advising a health management organization regarding use of fluoroquinolones. Based on the review by Dr. Cheng and colleagues, which of the following statements about restrictions in Australia regarding use of fluoroquinolones is most likely correct?

A. Quinolones are permitted in steer but not in cows

B. Ciprofloxacin is listed as an option in lower urinary tract infection only in patients with high fever

C. Moxifloxacin is listed as an option for empiric management of most cases of outpatient community-acquired pneumonia

2. Based on the review by Dr. Cheng and colleagues, which of the following statements about development of fluoroquinolone resistance in Australia compared to that in other countries is most likely correct?

A. In Echerichia coli, quinolone resistance rates in disease-causing isolates have plateaued at a moderate level in Australia

B. Quinolone resistance in locally acquired Campylobacter spp. is about the same in Australia as in most other countries

C. An increase in quinolone resistance in pneumococci in North America was noted following the introduction of levofloxacin into respiratory infection guidelines and widespread usage

D. Quinolone resistance in isolates of Campylobacter spp., Salmonella spp., and E. coli from a variety of food-producing animals and products is not uncommon in Australia due to importation of meat

3. Based on the review by Dr. Cheng and colleagues, which of the following statements about potential harms of restricting fluoroquinolone use, and strategies to eliminate those harms, would most likely be correct?

A. Quinolones can no longer be prescribed at all in Australia

B. Most recommended empirical regimens use quinolones, and appropriate empirical therapy would therefore be delayed

C. No strategies are currently available for quinolone therapy in severely ill, hospitalized patients

D. Quinolones can still be prescribed in Australia when they are necessary or the indicated preferred treatment

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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